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Surgical Neurology International

Editor-in-Chief: Nancy E. Epstein, MD, NYU Winthrop Hospital, Mineola, NY, USA.
SNI: Socio-Economics, Politics, and Medicine Editor
 James A Ausman, MD, PhD
 University of California at Los Angeles, Los Angeles, CA, USA
Open Access

Editorial

The devastating Venezuelan crisis

A. Venezuelan, James Ausman
James I and Carolyn R. Ausman Educational Foundation, Surgical Neurology International, Rancho Mirage, CA, United States.

E-mail: A. Venezuelan - jamesausman@mac.com; *James Ausman - jamesausman@mac.com

*Corresponding author:
James I. Ausman, MD, PhD,
James I and Carolyn R. Ausman
Educational Foundation,
70950 Fairway Drive, Rancho
Mirage, CA 92270, USA.
jamesausman@mac.com
Received : 05 June 19
Accepted : 05 June 19
Published : 26 July 19
DOI
10.25259/SNI_342_2019
Quick Response Code:
ABSTRACT
The Venezuelan crisis is filling the headlines and truly deserves the world’s attention. It is a wake-up call to all as it
holds relevant lessons for both developing and developed countries. The country suffers a severe humanitarian crisis.
Its economy has declined at a faster pace than any other peacetime economy worldwide. Hardship and repression
have led millions to flee the country creating a refugee crisis in Colombia and other neighboring countries, and
millions more are expected to flee unless conditions improve. It raises serious security concerns in the whole Western
Hemisphere. The country of Venezuela sits on and owns the largest oil reserves in the world. Oil helps explain the
“rent-seeking” behavior that is at the root of this crisis. (“Rent-seeking” is simply getting money from the government
for the oil it sells and giving little or nothing back to the government in return. -EEd) However, oil cannot be blamed
for this crisis – it helped Venezuela get out of the poverty trap and become a modern democratic society in the
20th century. This crisis comes from the perverse combination of bad politics, bad policy, and corruption that besieged
the country over the last 20 years. Since he was elected in 1998, Hugo Chávez paved the way to authoritarianism while
making the economy more vulnerable to the ups and downs of oil prices. Chávez died in early 2013. When Nicolás
Maduro, his anointed heir, was elected to succeed him, the economy was in bad shape and institutions were already
weak, but problems had been papered over thanks to high oil prices and the money the government made from its
sale. When oil prices were high worldwide, Venezuelan governments did not save money for possible future economic
losses. When oil prices began falling in 2014 and threatened the money from “rent-seeking” by many Venezuelans,
Maduro chose the road to overt authoritarianism instead of seeking to restore the basics of an open society and a
prosperous economy: the rule of law, property rights, transparency, prudent fiscal and monetary policy, and essential
public goods such as education, health, housing, transportation, and infrastructure. This paper is a brief history of
how the present Crisis in Venezuela developed and how it can be reasonably resolved. The Venezuelan people are
suffering. There are lessons here for everyone in the world (A Venezuelan and James Ausman).

Keywords: Dictatorship failure, Health crisis, Humanitarian crisis, Immigration, Oil economy disaster, Solutions,
Starvation, Venezuela crisis

Emeritus Editor-In-Chief note

Surgical Neurology International (SNI) received this paper from A. Venezuelan who left Venezuela
and now lives in South America. The person was recommended to SNI as highly reliable. The
person is nameless to SNI. The text has been checked as factual. Miguel A. Faria, MD has described
this article as “better than I have read in the American and international media, including the
BBC.”
This Editorial is followed by comments made by Miguel A. Faria, M.D., an SNI Associate Editor-
in-Chief in socioeconomics, politics, medicine, and world affairs of SNI. He is the author of Cuba
in Revolution: Escape from a Lost Paradise (2002). His upcoming book is America, Guns, and
Freedom: A Journey into Politics and the Public Health and Gun Control Movements (2019). His

is is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others
to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
©2019 Published by Scientific Scholar on behalf of Surgical Neurology International

Surgical Neurology International • 2019 • 10(145)  |  1

 Venezuelan and Ausman: The devastating Venezuelan crisis
website is https://haciendapublishing.com. Dr. Faria escaped
from Cuba in the 1960s in its transition to a Castro controlled
Communist country. He was educated as a neurosurgeon in
the USA and has been the Editor of two American medical
journals.
INTRODUCTION
Without having gone through a war or a natural catastrophe,
Venezuela suffers a grave humanitarian crisis and the worst
economic performance in the world, perhaps one of the
most serious in recent times. It comes from bad politics, bad
policy, and corruption. Chávez and Maduro managed $1
trillion in oil revenues over two decades, and the country is
in shambles.
Venezuela’s crisis is political, economic, and social. It worsens
at a dizzying speed and threatens to drag the country into
a failed state chaos. Bold reforms are needed to steer the
country out of its morass. Citizens must be empowered
through education and jobs instead of being kept subservient
to government handouts. The government’s footprint in the
economy must shrink, and the administration must focus on
essential public goods: health care, education, security, and
infrastructure. The country must open the doors to private
investment with clear rules and legal protection, and embrace
modernity instead of trying to live off its hydrocarbon
resources with a short-term vision. Reforms can succeed,
if implemented by new leadership with stable political
standing, conviction, and strong international support.
Under Chávez, elected president in 1998, Venezuela came
to experience one of the worst cases of Dutch disease in the
world. (“Dutch disease is the rapid increase in the production
of raw materials [like oil and gas] causing a decline in
other sectors of the economy. When the raw materials run
out [or are not produced-EEd], the economy can be in a
worse position than before. T. Pittenger “Dutch Disease;”
economicshelp.org; November 15, 2017) other countries in
the world have undergone Dutch disease in the past.
The current crisis is rooted in Venezuela’s society’s effort
to maintain its way of life with a short-term vision of
easy money. Venezuelans gave all the power to one man,
Hugo Chávez, who generated the illusion of prosperity
through short-sighted populism and sank the country
into communism and lawlessness by abolishing property
rights and the rule of law, by expanding the government’s
footprint in the economy, by over-regulating whatever is
left of a private sector, by destroying all institutions that
are key to a civilized society, and by allowing corruption
to contaminate all government’s functions. It is also the
story of the rise and decline of a revolution that went from
being applauded by many in the world to becoming an
illegitimate dictatorship.
Surgical Neurology International • 2019 • 10(145)  |  2
Some analysts find a parallel between Venezuela’s bankruptcy
today and the Spanish bankruptcy of the 16th century. Spain
wasted the gold and silver brought from the Americas on an
unsuccessful imperial policy, on droves of entitled noblemen,
and on the importation of manufactured goods. Venezuelan
petrodollars were spent similarly.
AN OIL STORY
Venezuela has a century-long oil history and the largest
oil reserves in the world: 360 billion barrels. Saudi Arabia
is the second with 270 billion barrels. An unprecedented
bonanza due to high oil prices in 2004-2008 brought a
windfall of $300 billion to the country. The money was spent
on consumption and on building international support for
the “Bolivarian Revolution” instead of investing in health,
education, infrastructure and modernization, and saving
for future generations. After the oil price boom, Venezuela
emerged more vulnerable to the ups and downs of oil.
Hugo Chávez died in early 2013 and his anointed heir,
Nicolás Maduro, took office. The collapse of oil prices in 2014
shed light on the weaknesses of an economy where private
investment had been systematically destroyed. Maduro’s
political footing eroded as living standards lavishly subsidized
for over a decade turned into hardship. He chose the road to
overt authoritarianism instead of seeking to restore the basics
of an open society and a prosperous economy: the rule of law,
property rights, transparency, prudent fiscal and monetary
policy, and essential public goods such as education, health,
housing, transportation, and infrastructure.
Short-termism and ignorance killed the golden goose.
Oil production fell from 3 million barrels a day in 1998
– 1.5 million in 2017 and continues plunging. It may close
at 600,000 barrels a day by year-end. The depression in
Venezuela has lasted for 5 years, its gross domestic product
loss exceeds 50%, and the end is not yet in sight. In the Great
Depression, the U.S. economy shrank by 30% and lasted only
3 years. Intense hyperinflation has impoverished Venezuelan
society since 2018: the annual inflation rate heads toward
500,000% this year. In the past 20 years, 60% of the companies
that existed in 1999 closed. The minimum wage is $3/month,
90% of the population is poor, and 15% of children are at risk
of dying from malnutrition.
About 85% of medicines are scarce or utterly unavailable,
while the number of people at risk rises. The vulnerable
population includes over 140,000 cancer patients, 300,000
with cardiological diseases, 300,000 chronic patients
(i.e.,  Parkinson’s and hemophilia), and 79,000 people with
HIV, who stopped receiving treatment since 2016 or receive
it intermittently. More than one million cases of malaria
were reported in 2018, a disease eradicated in Venezuela in
the 1940s. The shortage of medicines stems from foreign
 Venezuelan and Ausman: The devastating Venezuelan crisis
exchange controls and corruption, and $6 billion owed
by the government to pharmaceutical companies. Quality
control rules on medicines also eroded over time, allowing
poor quality medicines to enter the country. The lack of food
makes things worse.
Venezuela suffers one of the worst peacetime migratory crises
known in modern times, with 3 million migrants around the
world according to the United Nations High Commissioner
for Refugees and the World Organization for Migration.
Many have left on foot to neighboring countries, where they
live in shelters or on the streets. This figure is in the ranks
of Afghanistan (2.5 million refugees), Syria (6 million), and
Colombia (almost 7 million internally displaced persons).
The most recent electricity crisis is another example of the
failure of central control. The national electricity system
collapsed on March 7, 2019, after 15 years of mismanagement,
underinvestment, and corruption. Successive nationwide
blackouts began on March 7 and left the country without
electricity, water, functioning hospitals, public transportation,
and communications critical for payment system operations.
The government officially began to ration electricity a month
later, limiting service everywhere except Caracas, the capital,
where it fears social unrest. Power outages are frequent and
unpredictable, suggesting that the system is incapable of
generating and distributing enough power to meet even
post-rationing needs. The “new normal” implies electricity
with interruptions, irregular supply of water, partial and
unstable connectivity, lack of perishable food, reduced
working hours, schools and businesses closed on and off by
government decree, and a worsening health crisis.
WHAT WENT WRONG?
Venezuela was the second largest oil producer in the world
until 1960 when the Soviet Union displaced it, and the first
world exporter until the early 1970s, when Saudi Arabia
occupied that place. In the 1950s and 1960s, Venezuela was
one of the 20 wealthiest countries in the world measured in
per capita income. The state provided cheap loans, subsidies,
numerous jobs, and free public services, and made sure that
an overvalued currency made imported goods accessible.
Everyone got a little of what they wanted. Venezuela became
a society of rent seekers living in an ideal world with lots of
oil rent distributed by the government, making politicians
powerful.
Democracy was instituted in 1958 when Marcos Pérez
Jiménez (a military dictatorship) was ousted. A broad social
consensus helped fight right-wing military coups and secure
a fast victory over leftist guerrillas. People felt well despite
inequality (the top 20% captured 80% of the income) and 90%
of the voters supported the two-party system that allowed
70% of Venezuelans to be broadly considered middle class.
Prudent fiscal and monetary policies prevalent in the first
half of the 20th century gradually gave way to macroeconomic
populism. The outcomes left people unhappy and distrustful.
The decline of rent-seeking capitalism in the 1980s was
traumatic. Incomplete market reforms in the 1990s failed
for lack of popular support. The people did not understand
that it was impossible to get back the bonanza of the old
days. A military organization, the Bolivarian Movement 200
created by a group of military officers in 1983, decided to
strike a blow and launched two military coups in 1992. They
failed to gain access to power, but Hugo Chávez, one of its
most visible leaders, won considerable support.
Chávez won elections in 1998 offering the typical program
of a reformist nationalist military. In a carefully planned
sequence, between 1999 and 2006 he changed the
constitution, reformed institutions, and got full control of
the government and the media. He displaced the old political
class and replaced a watered-down version of “neoliberalism”
with controls and multiple forms of state interventionism.
Initially, Chavismo was an alliance of left-  and right-wing
politicians and intellectuals who shared “anti-system” views
since 1958, shunned neo-liberalism and, to varying degrees,
opposed representative democracy. The Chavista alliance
quickly moved to the left. The Cuba-Venezuela agreement
was forged in 2000. A close friendship between Chávez and
Fidel Castro led to the arrival of thousands of Cuban advisors
who took over strategic government functions and ended up
providing critical intelligence support to the government.
In 2001, Chávez was granted special powers to legislate
by decree. The land and oil reforms he enacted heralded
problems. The economy was far from improving, and people
felt disappointed. In late 2002, Chávez’s popularity had fallen
to <30%. Two things came to his aid: the failed 2002 coup
against him, and the boom in oil prices that began in 2004.
He rebuilt his political footing as an “invincible hero.”
In early 2003, Chávez took control of PDVSA, the national
oil company, after firing 20,000 of its highly skilled managers
and workers. PDVSA morphed from being a professionally-
run oil company to becoming the source of petty cash for
the government. He purged the Army and turned it into
another of his supporting pillars, and also sought to build up
his international standing as a righteous revolutionary that
successfully confronted conservative elites, a partial truth. In
any case, the old system died in 2002 when many of its key
players were defeated including the two traditional parties,
the trade unions linked to them, oil industry managers,
and businesspeople who, until then, had shared power in a
consensus-based oil rent distribution mechanism.
Then came another oil boom. Oil prices rose steadily to
over $100 a barrel in mid-2008 from the low $20s in 2001-
2003. Venezuelan oil exports added $300 billion to the
government’s coffers in 2004-2008. The world financial crisis
Surgical Neurology International • 2019 • 10(145)  |  3
 Venezuelan and Ausman: The devastating Venezuelan crisis
brought prices down precipitously in the second half of 2008
and caught Venezuela unprepared.
Nevertheless, the oil windfall had boosted Chávez’s standing.
Along with higher revenues came a surge in public spending,
with multiple subsidies and welfare policies known as
“missions.” These were programs to massify access to
education and health, subsidized food, free housing and
direct aid in money, seeking to take Venezuela to “zero
poverty” in 2021. Strict foreign exchange control was put in
place in 2003 for political reasons: it allowed the government
to rein in the private sector which was (and is) dependent
on foreign currency generated by oil – private exports that
have traditionally been minimal. The Bolivar was artificially
overvalued, to allow for cheap imports.
The government showed encouraging results to the world:
the poorest doubled their consumption capacity, poverty
dropped from 70% in 1999 to 30% in 2013, and the
United Nations Development Program noted that the human
development index had risen to 0.764, ranking Venezuela in
67th place out of 187 countries. It was Chavismo’s golden age.
Venezuela sought to become a regional power by helping left-
wing governments rise in many Latin American countries and
by providing them strong financial support to stay in power.
The goal was to create an alternative axis to the United States.
The Bolivarian Alliance for the Peoples of Our America was
born in 2004 and Petrocaribe, a scheme geared to subsidize
imports of Venezuelan oil for other countries was begun in
2005. Petrodollar diplomacy secured for Chávez (and more
recently, Maduro) the votes needed to survive challenges in the
international forums. Billions of dollars went to fulfill this goal.
According to some calculations, facilities granted to Petrocaribe
countries cost Venezuela $50 billion between 2000 and 2017.
THE DECLINE
In 2007, Venezuela officially became a “socialist state.” The
government began by purchasing companies privatized in
the early 1990s such as the National Telephone Company
(Cantv) in 2007, the Orinoco Steel Company (Sidor) in 2008,
and Banco de Venezuela, the largest commercial bank in the
country in 2009. Subsequently, the government moved to
expropriate property without compensation, as attested by
billions of dollars in lawsuits filed at the International Center
for Settlement of Investment Disputes (ICSID) attest. In
large farms, the process began earlier by fostering, or at least
tolerating, invasions of these farmlands by peasants.
About 1000 companies were nationalized between 2005
and 2017. The plan was to put all the fundamentals of
the economy in the hands of the government, leaving a
small space for the private sector. Companies became
subject to rigorous controls on prices, and their access to
foreign currency, extending even to their ability to choose
Surgical Neurology International • 2019 • 10(145)  |  4
to whom to sell. Companies were often forced to sell at a
loss and also to sell at least half of their production to the
government.
Non-oil output fell, while oil output was also trending
down. Rice production fell to 405,000 tons in 2017 from
900,000 in 2007; corn production went down to 1 million
tons in 2017 from 2.4 million in 2007, and sugarcane,
dropped to 3.5 million tons in 2017 from 8 million in 2006.
From 170,000 vehicles produced in 2007, the automotive
industry production dropped to only 2768 in 2017. Liquid
steel manufacture went from 4 million tons in 2008 to
270,000 in 2017, and aluminum went from 600,000 tons
in 2007 to 400,000 10  years later. No sector escaped the
destruction.
While oil prices were high, massive imports masked the effect
of declining production of local goods. When oil exports
began to shrink, imports fell, and shortages soared. By 2017,
imports were already at a quarter of their peak 2012 level,
when Chávez was campaigning for reelection. Rationing
became a fact of everyday life. Black market flourished.
THE ROAD TO OUTRIGHT DICTATORSHIP
Personalism in leadership and corruption drove many
Venezuelans away from Chávez. The poor results of
“socialism” with low oil revenues drove away more. The
political erosion of chavismo without both petrodollars and
Chávez became evident. Nicolás Maduro, Chávez’s political
heir, has managed to hold on to power thanks to the support
of the military and, increasingly, of paramilitary groups
serving as his “Republican Guard.”
Maduro called elections for a National Constituent Assembly
in 2017 without abiding by the constitution. Those elections
were not recognized as legitimate by the opposition and by
foreign governments, including the United States and several
members of the European Union. He then called for sham
presidential elections in May 2018 also rejected as unfair and
illegal by the opposition and by the international community.
Several parties had been made illegal, and many opposition
leaders were prevented from running for office, pushed to
exile, or jailed.
The opposition considers Maduro’s new 6-year term (2019-
2025) illegitimate. It declared an absolute vacancy of the
Presidency of the Republic and, according to the constitution,
appointed Juan Guaidó as Interim President. Sixty countries
recognized Guaidó and are working to support a solution to
the political crisis through free and fair elections as soon as
possible. They agree that these changes can only happen after
Maduro steps down. The United States government is the
strongest and most assertive opponent of the Maduro regime
and has been applying major sanctions since 2017.
 Venezuelan and Ausman: The devastating Venezuelan crisis
WHAT’S NEXT?
The road to recovery starts with politics. Maduro’s departure
is the prerequisite for free and fair elections that bring new
leaders to power. Reforms can only succeed if they are carried
out by new leadership, with a robust political standing
so that reforms can take place democratically, and with
conviction, because these changes will neither be quick nor
easy. Decision-making will have to be inclusive, with buy-in
from critical constituencies. Strong international support is
also essential. In the economy, it must be back to basics: the
rule of law, property rights, practical beliefs for expectations,
and a social safety net for all. Three key institutions need to
be rebuilt quickly: the judiciary, to restore the rule of law;
PDVSA, to feed the country; and the central bank, to restore
confidence in the currency.
A reform plan called “Plan País” has been crafted and
approved by the opposition. It is a sensible blueprint. It
foresees humanitarian assistance (food, medicines, and
health care), macroeconomic stabilization, structural reforms,
fiscal reforms, imports to fill the shelves early on, and direct
subsidies to support the most vulnerable population. It
contains policies geared to reactivate the oil industry and to
attract foreign investment. Agriculture and industry need to
get back on their feet, along with programs to generate quality
jobs. All of this is to be driven by the private sector.
Security challenges include the pressing need to regain control
over the territory, now plagued by illicit drugs and arms
businesses and multiple paramilitary groups. The Armed
Forces, law enforcement agencies, and the public administration
all need to be rebuilt. A complex debt restructuring also awaits,
with over $160 billion in foreign debt in default. All of this
means that Venezuela’s recovery will require substantial upfront
funding from the International Monetary Fund, multilateral
institutions, bilateral export financing agencies, foreign
donations, and the debt restructuring process. Private capital
will follow, once the dust settles.
(I want to express my gratitude to the author of this paper for
allowing Surgical Neurology International (SNI) to bring this
objective information to our readers that is not easily obtainable
elsewhere. Its value is in showing how corruption, the desire
for power and money in a country can affect its government
leaders, and ruin the lives of the people of the country who are
the patients of our colleagues there and elsewhere. James I.
Ausman, MD, PhD-EEd).
COMMENTS BY MIGUEL A. FARIA, MD
SNI Associate Editor in Chief: Socioeconomics, Politics,
Medicine, and Would Affairs
This is an excellent review article/editorial for which the
author(s) should be congratulated. It describes perceptibly
and accurately developments in Venezuela from the time
the socialist, revolutionary-turned military dictator, Hugo
Chávez, came to power in 1998 promising prosperity to the
present age under his successor Nicolás Maduro, bringing full
devastation and disaster whose seeds had been planted with
the advent of socialism in the 1990s. All this is well recounted
in this article, better than I have read in the American and
International Media, including the BBC.
The author(s) describe how Venezuela was afflicted with the
Dutch disease, a disease that also afflicted Mexico with the
same commodity, oil, during the presidency of José López
Portillo in the early 1980s. Likewise, it was a disaster for
Mexico. However, unlike in Venezuela, the citizens of our
neighbor to the south eventually voted out the progressive
and corrupt Institutional Revolutionary Party, and voted in
the more accountable, free-market oriented, conservative
National Action Party (PAN), bringing and consolidating
relative prosperity and stability in Mexico.
The tragic story of Cuba in the past 60  years is even more
apropos. The heart-rending story of Venezuela cannot but
bring to mind the even more disastrous events that took
place on the Caribbean island since the Cuban Revolution of
1959. This was exactly 40 years before the advent of dictator
Hugo Chávez in Venezuela. One cannot help but draw social,
economic, and political parallels between the two nations.
Cuba, like Venezuela, was a prosperous country, despite
the much-touted ruthlessness and corruption of President
Fulgencio Batista. Even with the turbulent years of revolutionary
violence in the 1950s preceding the Castro revolution, Cuba’s
prosperity was unparalleled. This was true for education,
standard of living, and health care. The Cuban socialist
revolution ended all of that – and most importantly, it
extinguished freedom.
The author(s) write: “Venezuela was the second largest oil
producer in the world until 1960 when the Soviet Union
displaced it, and the first world exporter until the early 1970s
when Saudi Arabia occupied that place. In the 1950s and
1960s, Venezuela was one of the 20 wealthiest countries in the
world measured in per capita income. The state provided cheap
loans, subsidies, numerous jobs, and free public services, and
made sure that an overvalued currency made imported goods
accessible. Everyone got a little of what they wanted. Venezuela
became a society of rent seekers living in an ideal world
with lots of oil rent distributed by the government, making
politicians powerful. Democracy was instituted in 1958 when
Marcos Pérez Jiménez (a military dictatorship) was ousted…”
Indeed, a great future was squandered by mismanagement,
and eventually the formation of a corrupt socialist dictatorship,
the same as in Cuba. In my book, “Cuba in Revolution: Escape
From a Lost Paradise” (2002), I wrote: “In 1958, just prior to
the revolution, Cuba had three times as many doctors as all of
Surgical Neurology International • 2019 • 10(145)  |  5
 Venezuelan and Ausman: The devastating Venezuelan crisis
the Central American countries combined, but there was no
oversupply because freedom and the ordered liberty of the free
market reigned.” Public health was a la par with the United
States. Life expectancy in Cuba in 1958 was rising at the same
pace as those of industrialized European countries. Cuba had
the lowest infant mortality rate in Latin America. In education,
Cuba also ranked at the top and had the third highest literacy
rate in Latin America. Just before the Revolution, prosperity
reigned, and the standard of living was comparable to those
in many European countries. Even without oil, the economy
was thriving, the same as with Venezuela in the decade of the
2000s, but all of this ended in both countries with the advent of
socialism and the loss of freedom.
The decline and eventual devastation of the two countries
began in earnestness once they openly declared themselves
socialist States: Cuba in 1961, immediately after the travesty
of the Bay of Pigs, and Venezuela in 2007, after Chavez,
like Fidel, had fully consolidated power. Both proceeded
with nationalization and expropriation of private property.
Freedom of the press and private education ended, and full
socialist dictatorship became the order of the day.
In Cuba, communist dictatorship and misery still reigns
due to the police state totalitarianism enforced in an
island by the evil genius of Fidel Castro. However, neither
Chávez nor Maduro had the genius component, and the
Venezuelan situation, which can only be characterized as
anarcho-tyranny in the political spectrum, will not last much
longer. In fact, Maduro has lasted this long not only due
to the support of the top military ranks led by the corrupt
henchmen of Chávez and Maduro, who fear prosecution for
corruption and war crimes but also due to the bolstering of
four authoritarian nations: Russia, China, Iran, and Cuba.
Juan Guaidó, the President of the National Assembly, has
already been recognized as the legitimate President of Venezuela
by the US and most of Latin America. The dictatorship will
soon collapse, and it is only a matter of time before freedom
returns to the long-suffering South American nation, the
proud country of Simón Bolívar, the great Liberator. I want to
thank the author(s) again for bringing the issue of Venezuela
eloquently and incisively to the intelligent readers of SNI.
COMMENTS BY RUSSELL L. BLAYLOCK, MD
SNI Associate Editor-in-Chief, Neuroinflammation Section
The paper on Venezuela demonstrates, quite well, a repeated
methodology by the revolutionary left. First come, the
promises and extensive use of propaganda – painting a
picture of a coming utopia, should the people be wise enough
to elect the leftist “progressive.” Then follows the welfare
state, which initially grows and the plight of the poor seems
Surgical Neurology International • 2019 • 10(145)  |  6
to actually improve. This gives the new leftist president time
to consolidate his power and build his police state. Of course,
the money is created out of nothing – mere entries in a ledger
of the state or from the wealth built by the previous free
enterprise government. Once the police state is completed,
then the initial utopian illusion is dropped. Rapidly, the
totalitarian state rises and all references to the utopia fade into
the distance. Elections are then rigged and true democracy
disappears. Enemies are arrested and removed from positions
that might endanger the new totalitarians. At this stage, the
economy begins to collapse, as it was built on fiat (fake)
money. The stage of hyperinflation rises, international
investment dries up, banks are taken over by the government,
and commerce is destroyed. Starvation is close behind. Store
shelves are empty, food lines grow, people migrate in mass
numbers to other countries to avoid this devastation of the
economy; and to keep their power, the government becomes
increasingly violent and oppressive. At that stage, we have
full communism. All pretense of this being a revolution for
the “little people” continues to be believed only by the simple
minded and those benefiting from the new bureaucracy and/
or the enforcers of the police state.
Miguel’s comments are beautifully crafted and poignant.
With his addition, all should understand this process and the
enormous value of the private property, the rule of law based
on transcended natural law, a constitutional system that
guarantees liberty and an economic system that recognizes
private contracts and negotiations outside the state. The evil
of collectivism is contained in this wonderful paper.
SNI receives papers on socioeconomics and politics from
around the world due to its devotion to Freedom of the Press,
its desire to enlighten our readers everywhere with the truth in
its concern about the health and welfare of people, who are our
Patients everywhere. (James I. Ausman, MD, PhD, Emeritus
Editor, SNI, an operational part of a charitable foundation,
The James I and Carolyn R Ausman Educational Foundation).
These Editorials may not necessarily reflect on the opinions of
the members of the SNI Board and publishers.
Comments from SNI’s readers are welcomed and will be
published if appropriate to this subject.
Disclaimer
The views and opinions expressed in this article are
those of the author and do not necessarily reflect
the  official  policy  or position of the Journal or its
management.
How to cite this article: Venezuelan A, Ausman J. The devastating
Venezuelan crisis. Surg Neurol Int 2019;10:145.